Portable cryosurgical apparatus

ABSTRACT

This invention relates to cryosurgery, and more particularly to the delivery and application of liquified gas coolant to living tissue in order to necrotize the same.

United States Patent 1191 Tromovitch July 16, 1974 PORTABLE CRYOSURGICALAPPARATUS 3,485,060 12/1969 Ziegler 128/303.1 x 3,630,203 I2 I97] S ll't'l. I28 303.l I76] Inventor: Theldore Tromovltch 1667 3,651,813 311972128/3031 Escalante Way, Burlmgame, Callf. 94010 FOREIGN PATENTS ORAPPLICATIONS I FI'ZIIICC [211 Appl No: 289,753 OTHER PUBLICATIONSMarshall, Principles and Practice of Operative Den- 52 us. c1128/303.1,222/382, 222/383, ph'ladelphia 8 222/397, 222538 and London,1901. [51 Int. Cl A61b 17/36, 867d 5/40 [58 Field 01 Search..'B67d/5/54; 128/303.1; Primary Emmmer(hanmng Pace 222 397 39 332 33353 Attorney, Agent, or FzrmRobert Charles H1II [56] References Cited[57] ABSTRACT UNITED STATES PATENTS This invention relates tocryosurgery, and more partic- 367,474 8/1887 Truman 222/538 X ularly tothe delivery and application of Iiquified gas Donathen X coolant totissue in order to necrotize the ame I,009,980 ll/I9Il Leisure et al.1,651,256 1 1/1927 Davis 222/39? 2 Claims, 3 Drawing Figures 1 PORTABLECRYOSURGICAL APPARATUS BACKGROUND OF THE INVENTION DESCRIPTION OF THEPREFERRED EMBODIMENT Referring now to FIG. 1, there is illustrated acryo- It has long been known in the prior art to use liquified 5 geniesystem including a supply container having a gas (such as helium,nitrogen, oxygen, air, freon, zenon, carbon dioxide, etc.) to freezehealthy or diseased tissue, and thereby necrotize the tissue. Forinstance, one well-known use of liquified gas in cryosurgery is theremoval of lesions, both on the skin and internally. Usually, the objectis to remove the lesion by destroying the tissue; in other cases, theobject is the destruction of the tissue while maintaining adjacentportions of the tissue structure in place, such as in the walls of vitalorgans. As used herein, lesion means diseased tissue which is to befrozen; the destruction of lesions includes removal of tissue forcosmetic purposes, and killing of tissues as a complimentary modality tosurgical procedures.

However, prior art devices have been very inefficient due to very pooror lack of insulation in the containers holding the cryogenic liquidwith the result that ambient heat prematurely gasifies the cryogenicliquid and same is vented to atmosphere through safety exhaust means,etc. A further drawback of prior art devices resides in their awkwardconstruction whereby the container holding the cryogenic liquid isoftentimes integrally associated with the discharge nozzle for thecryogenie fluid. In many cases such a construction leads to severeoperator fatigue and also hampers the use of the apparatus since onlyone hand is free to operate the surgical device while the operatorsother hand is occupied with the holding of the container or theoperation of levers, etc. A still further disadvantage of some prior artdevices is that they include 17 liter or 30 liter tanks which containthe coolant, thus making thev structure heavy and cumbersome andalmost'impossible to transport for house calls and/or visits to nursinghomes and hospitals.

Accordingly, it is the primary object of the present invention toprovide improved cryosurgical apparatus in which the cryogenic liquidiscontained in a completely. insulated container and which is normallynot vented to atmosphere. 1

A further object. of the invention is to provide apparatus which doesnot require the use ofa finger or footsuitable cryogenic liquid 12contained therein. The container 10 comprises a base member 14 intowhich is seated an insulated bottle 16 which is preferably a doublewalled vacuum bottle.

. The cryogenic liquid 12 may be any nonexplodable, nontoxic, lowmolecular weight substance. Of those substances meeting theaforementioned requirements,

' the choice of liquid will depend upon the temperature operated lever,etc.. during actual surgical use of the device.

A'further object of the invention is the provision of a simple manuallyoperated fluid pressure producing device for selectively applyingpressure to the cryogenic fluid in the container for delivery of same tothe outlet nozzle. p

A still further object is to provide a small selfcontained handcarryable apparatus which is readily portable.

BRIEF DESCRIPTION OF THE DRAWINGS of the device shown in FIG. 1 whenrotated 90 to illustrate additional features of the inventionyand-v FIG.3 is a top plan view of the present invention.

at which the surgeon or dermatologist chooses to perform the operation.For most applications the preferred substance is liquid nitrogen.

The top of the insulated bottle 16 is provided with a removable closure18 which engages the bottle in fluid tight relation as shown in thedrawing. As best shown in FIG. 2, the closure 18 is provided with threetubular orifices 20, 22 and 24 extending therethrough for communicationwith a chamber 26 defined by the insulated bottle 16. g

Extending through the orifice 20 is a tubing 28, preferably of nylon,having a first end 30 submerged below the level of the cryogenic liquid12. Near the second or remote end 32 of tubing 28 there is providedinsulated handle means 34. A desirable material for the thermallyinsulative handle 34 comprises plastic layers,

such as polystyrene, superimposed upon one another and then heated andjoined in a vacuum chamber. Such materials exhibit very poor thermalconductivity and also have great tensile strength. In addition,insulative materials as shown at 36 may be placed between the handle 34and tube end 32 as desired.

At the remote end 32 of the tubing 28 there is provided a nozzle means38 which is removably connected to a shank 40 formed in the outer end ofhandle 34 and into which the end 32 of tubing 28 terminates. The shank40 may receive any one of several nozzles, such as by a threadedconnection, and as shown in FIGS. 1

and 3 an auxiliary nozzle 42 may be stored on a shank formedon the topof closure 18. All such nozzles may be regulated in a known fashion,such as by rotating same, from a completely closed position to a finemistlike spray or a small diameter highly localized stream.

considerable periods of time and it is obvious that excessive weight orawkwardness caused by having to move the liquid container duringoperation is not desirable.

Referring back to-FIG. 2, it may be observed that a second flexibletubing 46 communicates through closure orifice 22 with the space locatedin chamber 26 above the level of cryogenic liquid 12. The outer end 48oftube 46 is suitably attached to a conventional air bulb 50. Thefair bulbis used to selectively apply pressure to the space in chamber 26 locatedabove the level of cryogenic liquid 12. A suitable valve means 52, suchas a screw valve, may be employed to close off the air bulb 50 when sameis not in use.

As also shown in FIG. 2, there is provided safety valve means 54 formedon the closure 18 and in communication with closure orifice 24 whichorifice is in communication with the space in chamber 26 located abovethe level of cryogenic liquid 12. The safety valve 54 is set to open atany given pressure above the normal pressure maintained in chamber 26 ofcontainer 10. For example, the valve may be set to open at any time thepressure in chamber 26 rises three pounds above normal pressure in saidchamber, such for example as when pressure is being applied to saidchamber from the air bulb 50 and exceeds the desired level. FIG. 3illustrates the relative positions on the enclosure 18 of tubing 28,tubing 46, auxiliary nozzle 42, and safety valve means 54.

During operation of the device of the present invention, the containeris filled with liquified gas coolant, such as liquid nitrogen, to asuitable level. The operator then directs the nozzle 38 toward thetissue and, after opening valve 52, administers pressure to the chamber26 above the level of cryogenic liquid 12 by squeezing air bulb 50. Thispressure forces the liquid nitrogen 12 into delivery tube 28 and throughnozzle 38. The length of delivery tube 28 can be selected such that bythe time the cryogenic fluid reaches the outlet orifice of nozzle 38, itcomprises a desired gas-liquid ratio, such as, for example, 90 percentgas and 10 percent liquid. It should also be understood that theduration of use also influences the gas-liquid ratio. Thus, the longerthe continuous use, the greater the percentage of liquid flowing throughnozzle 38. Typical usages vary from five seconds up to and includingseveral minutes. If at any time during operation of the device thepressure in chamber 26 exceeds the desired level, the pressure safetyvalve 54 will open and vent the chamber to atmosphere until such time asconditions have stabilized.

It can therefore be seen that the new and improved cryosurgicalapparatus of the present invention provides a portable self-containedunit which is easy to operate in a manner that maximizes the effectiveuse of the coolant.

' What is claimed is:

l. A portable cryosurgical instrument comprising: insulated containermeans having an upper end and a lower end; a quantity of cryogenicliquid within said container means having an upper level;

removable closure means sealably engaging the upper end of saidcontainer means;

first tubular means extending through said closure means and having oneend thereof communicating with said cryogenic liquid below the upperlevel thereof for selectively transferring said liquid from saidcontainer to a spray nozzle means located at the other end of said firsttubular means;

means for selectively administering pressure through said closure meansto the upper level of said cryogenic liquid to force said liquid throughsaid first tubular means; direct response safety valve means on saidclosure means for venting said container to atmosphere when the pressuretherein exceeds a predetermined level; and

insulated handle means on said other end of said first tubular meansnear said nozzle means;

whereby effective use is made of said cryogenic liquid so thatnumerouspatients may be treated at different locations on one fill of cryogenicliquid.

2. The portable cryosurgical instrument of claim 1 additionallycomprising spray nozzle storage means on said container closure means.

1. A portable cryosurgical instrument comprising: insulated containermeans having an upper end and a lower end; ''a quantity of cryogenicliquid within said container means having an upper level; removableclosure means sealably engaging the upper end of said container means;first tubular means extending through said closure means and having oneend thereof communicating with said cryogenic liquid below the upperlevel thereof for selectively transferring said liquid from saidcontainer to a spray nozzle means located at the other end of said firsttubular means; means for selectively administering pressure through saidclosure means to the upper level of said cryogenic liquid to force saidliquid through said first tubular means; direct response safety valvemeans on said closure means for venting said container to atmospherewhen the pressure therein exceeds a predetermined level; and insulatedhandle means on said other end of said first tubular means near saidnozzle means; whereby effective use is made of said cryogenic liquid sothat numerous patients may be treated at different locations on one fillof cryogenic liquid.
 2. The portable cryosurgical instrument of claim 1additionally comprising spray nozzle storage means on said containerclosure means.